Abigail Silva1, Yamile Molina2, Bijou Hunt3, Talar Markossian4, Nazia Saiyed3. 1. Department of Public Health Sciences, Loyola University Stritch School of Medicine, Chicago, IL, United States. Electronic address: asilva8@luc.edu. 2. Division of Community Health Sciences, University of Illinois School of Public Health, Chicago, IL, United States. 3. Sinai Urban Health Institute, Chicago, IL, United States. 4. Department of Public Health Sciences, Loyola University Stritch School of Medicine, Chicago, IL, United States.
Abstract
INTRODUCTION: The Affordable Care Act's (ACA) preventive services provision (PSP) removes copayments for preventive services such as cancer screening. We examined: 1) whether a shift in breast cancer stage occurred, and 2) the impact of the provision on racial/ethnic disparities in stage. MATERIALS AND METHODS: Data from the National Cancer Database were used. The pre- and post-PSP periods were identified as 2007-2009 and 2011-2013, respectively. Proportion differences (PDs) and 95% confidence Intervals (CIs) were calculated. RESULTS: All three racial/ethnic groups experienced a statistically significant shift toward Stage I breast cancer. Pre-PSP, the black:white disparity in Stage I cancer was -9.5 (95% CI: -8.9, -10.4) and the Latina:white disparity was -5.2 (95% CI: -4.0, -6.1). Post-PSP, the disparities improved slightly. DISCUSSION: Preliminary data suggest that the ACA's PSP may have a meaningful impact on cancer stage overall and by race/ethnicity. However, more time may be needed to see reductions in disparities. Published by Elsevier Ltd.
INTRODUCTION: The Affordable Care Act's (ACA) preventive services provision (PSP) removes copayments for preventive services such as cancer screening. We examined: 1) whether a shift in breast cancer stage occurred, and 2) the impact of the provision on racial/ethnic disparities in stage. MATERIALS AND METHODS: Data from the National Cancer Database were used. The pre- and post-PSP periods were identified as 2007-2009 and 2011-2013, respectively. Proportion differences (PDs) and 95% confidence Intervals (CIs) were calculated. RESULTS: All three racial/ethnic groups experienced a statistically significant shift toward Stage I breast cancer. Pre-PSP, the black:white disparity in Stage I cancer was -9.5 (95% CI: -8.9, -10.4) and the Latina:white disparity was -5.2 (95% CI: -4.0, -6.1). Post-PSP, the disparities improved slightly. DISCUSSION: Preliminary data suggest that the ACA's PSP may have a meaningful impact on cancer stage overall and by race/ethnicity. However, more time may be needed to see reductions in disparities. Published by Elsevier Ltd.
Entities:
Keywords:
Affordable care act; Breast cancer; Cancer stage; Disparities; Insurance
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